Paediatric falls: An analysis of patterns of injury and associated mortality in urban India.

Background: Falls are some of the most common childhood injuries. However, for vulnerable children in low- and middle-income countries (LMICs) such as India, mortality from a fall is nearly three times that of high-income countries. Despite fall being a leading cause of paediatric injury, detailed data from LMICs remain sparse.

Intubation and In-Hospital Mortality After Trauma With Glasgow Coma Scale Score Eight or Less-A Cohort Study.

Introduction: Most trauma societies recommend intubating trauma patients with Glasgow Coma Scale (GCS) scores ≤8 without robust supporting evidence. We examined the association between intubation and 30-d in-hospital mortality in trauma patients arriving with a GCS score ≤8 in an Indian trauma registry.

Methods: Outcomes of patients with a GCS score ≤8 who were intubated within 1 h of arrival (intubation group) were compared with those who were intubated later or not at all (nonintubation group) using various analytical approaches.

Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study.

Background: Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care.

Profile and triage validity of trauma patients triaged green: a prospective cohort study from a secondary care hospital in India.

Objectives: To evaluate the profile of non-urgent patients triaged 'green', as part of a triage trial in the emergency department (ED) of a secondary care hospital in India. The secondary aim was to validate the triage trial with the South African Triage Score (SATS).

Design: Prospective cohort study.

Facilitators and barriers impacting in-hospital Trauma Quality Improvement Program (TQIP) implementation across country income levels: a scoping review.

Objective: Trauma is a leading cause of mortality and morbidity globally, disproportionately affecting low/middle-income countries (LMICs). Understanding the factors determining implementation success for in-hospital Trauma Quality Improvement Programs (TQIPs) is critical to reducing the global trauma burden. We synthesised topical literature to identify key facilitators and barriers to in-hospital TQIP implementation across country income levels.

Towards definitions of critical illness and critical care using concept analysis.

Objective: As 'critical illness' and 'critical care' lack consensus definitions, this study aimed to explore how the concepts' are used, describe their defining attributes, and propose potential definitions.

Design And Methods: We used the Walker and Avant approach to concept analysis. The uses and definitions of the concepts were identified through a scoping review of the literature and an online survey of 114 global clinical experts.

Patterns of Head and Neck Injuries in Urban India: A Multicenter Study.

Objective: The pattern of head and neck injuries has been well studied in high-income countries, but the data are limited in low- and middle-income countries, which are disproportionately affected by trauma. We examined a prospective multicenter database to describe patterns and outcomes of head and neck injuries in urban India.

Study Design: Retrospective review of trauma registry.

Mortality from fall: A descriptive analysis of a multicenter Indian trauma registry.

Introduction: Fall is the second most common mechanism of trauma worldwide after road traffic injuries. Data on fall predominantly comes from the high-income countries (HICs) and mostly includes injuries in children and elderly. There are very few studies from low- and middle-income countries(LMICs) that describe fall related injuries other than fragility fractures in elderly.

Glasgow coma scale compared to other trauma scores in discriminating in-hospital mortality of traumatic brain injury patients admitted to urban Indian hospitals: A multicentre prospective cohort study.

Background: Glasgow Coma Scale (GCS) is one of the most commonly used trauma scores and is a good predictor of outcome in traumatic brain injury (TBI) patients. There are other more complex scores with additional physiological parameters. Whether they discriminate better than GCS in predicting mortality in TBI patients is debatable.

The State of Global Trauma and Acute Care Surgery/Surgical Critical Care.

Trauma is a leading cause of morbidity and mortality globally, with a significant burden attributable to the low- and middle-income countries (LMICs), where more than 90% of injury-related deaths occur. Road injuries contribute largely to the economic burden from trauma and are prevalent among adolescents and young adults. Trauma systems vary widely across the world in their capacity of providing basic and critical care to injured patients, with delays in treatment being present at multiple levels at LMICs.

A cohort study of differences in trauma outcomes between females and males at four Indian Urban Trauma Centers.

Background Studies from high income countries suggest improved survival for females as compared to males following trauma. However, data regarding differences in trauma outcomes between females and males is severely lacking from low- and middle-income countries. The objective of this study was to determine the association between sex and clinical outcomes amongst Indian trauma patients using the Australia-India Trauma Systems Collaboration database.

Mortality and Risk Factors in Isolated Traumatic Brain Injury Patients: A Prospective Cohort Study.

Introduction: Outcomes in patients with isolated traumatic brain injury (iTBI) have not been evaluated comprehensively in low-income and middle-income countries. We aimed to study the in-hospital iTBI mortality and its associated risk factors in a prospective multicenter Indian trauma registry.

Methods: Patients with iTBI (head and neck Abbreviated Injury Score ≥2 and other region Abbreviated Injury Score ≤2) were included.

Perceived usefulness of trauma audit filters in urban India: a mixed-methods multicentre Delphi study comparing filters from the WHO and low and middle-income countries.

Objective: To compare experts' perceived usefulness of audit filters from Ghana, Cameroon, WHO and those locally developed; generate context-appropriate audit filters for trauma care in selected hospitals in urban India; and explore characteristics of audit filters that correlate to perceived usefulness.

Design: A mixed-methods approach using a multicentre online Delphi technique.

Setting: Two large tertiary hospitals in urban India.

Management of pancreatic trauma in urban India: A multicenter study.

Background: Pancreatic trauma occurs in 0.2-2% of patients with blunt trauma and 1-12% of patients with penetrating trauma. The mortality and morbidity rates range from 9 to 34% and 30-60% respectively.

Association of age and severe injury in young motorcycle riders: A cross-sectional study from Karachi, Pakistan.

Introduction: The burden imposed by motorcyclist deaths and injuries is high in low- and middle-income countries. Many injured motorcycle riders in these settings are underage. The aim of this study was to assess the association between age and severe injury in young motorcycle riders.

A pilot multicentre cluster randomised trial to compare the effect of trauma life support training programmes on patient and provider outcomes.

Introduction: Trauma accounts for nearly 10% of the global burden of disease. Several trauma life support programmes aim to improve trauma outcomes. There is no evidence from controlled trials to show the effect of these programmes on patient outcomes.

Association of adolescents' independent mobility with road traffic injuries in Karachi, Pakistan: a cross-sectional study.

Objective: Participation in walking, cycling and taking public transportation without adult supervision is defined as independent mobility of children and adolescents. The association between adolescents' independent mobility and road traffic injury (RTI) is unclear. The purpose of this study is to determine measures of adolescents' independent mobility associated with RTIs in an urban lower middle-income setting.

'Coming home does not mean that the injury has gone'-exploring the lived experience of socioeconomic and quality of life outcomes in post-discharge trauma patients in urban India.

Trauma results in long-term socioeconomic outcomes that affect quality of life (QOL) after discharge. However, there is limited research on the lived experience of these outcomes and QOL from low - and middle-income countries. The aim of this study was to explore the different socioeconomic and QOL outcomes that trauma patients have experienced during their recovery.

Association between triage level and outcomes at Médecins Sans Frontières trauma hospital in Kunduz, Afghanistan, 2015.

Background: Five million people die annually due to injuries; an increasing part is due to armed conflict in low-income and middle-income countries, demanding resolute emergency trauma care. In Afghanistan, a low-income country that has experienced conflict for over 35 years, conflict related trauma is a significant public health problem. To address this, the non-governmental organisation Médecins Sans Frontières (MSF) set up a trauma centre in Kunduz (Kunduz Trauma Centre (KTC)).

Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis.

Introduction: Trauma accounts for nearly one-tenth of the global disability-adjusted life-years, a large proportion of which is seen in low- and middle-income countries (LMICs). Trauma can affect employment opportunities, reduce social participation, be influenced by social support, and significantly reduce the quality of life (QOL) among survivors. Research typically focuses on specific trauma sub-groups.

Outcomes of Renal Trauma in Indian Urban Tertiary Healthcare Centres: A Multicentre Cohort Study.

Background: Renal trauma is present in 0.5-5% of patients admitted for trauma. Advancements in radiologic imaging and minimal-invasive techniques have led to decreased need for surgical intervention.

Measuring post-discharge socioeconomic and quality of life outcomes in trauma patients: a scoping review.

Purpose: Trauma is a global public health challenge. Measuring post-discharge socioeconomic and quality-of-life outcomes can help better understand and reduce the consequences of trauma.

Methods: We performed a scoping review to map the existing research on post-discharge outcomes for trauma patients, irrespective of the country or setting in which the study was performed.